| NPI | 1689114654 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENE CASANOVA Medical Director 954-526-0840 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME78770) |
| Enumeration Date | 2017-02-24 |
| Last Update Date | 2017-02-24 |